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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Advocacy & Compliance

Healthesystems’ Advocacy & Compliance experts are essential in the management of pharmacy and ancillary benefits for our clients. By tracking and influencing regulatory activity, our team stays  ahead of evolving trends and identifies opportunities to advocate on behalf of our clients, their injured workers, and the broader industry.

The Advocacy & 
Compliance Team

Monitors and reports on proposed and pending regulatory changes that impact workers' comp, helping shape effective program strategies

Advocates for fair and balanced public policy through proactive engagement with regulators, customers, and other stakeholders throughout the rulemaking lifecycle

Supports operational compliance by providing guidance to internal stakeholders and external partners during the implementation of new regulatory changes

Regulatory Recap

A weekly e-newsletter informed by the Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers’ comp.
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WCRI Publishes New Study on High-Cost Back and Shoulder Injuries

Reviewing 194,000 claims, the report found that claims with degenerative comorbid conditions are 58% more likely to become a high-cost claim.
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August 11, 2025

Washington State Issues Draft of PTSD Clinical Guidelines

Open to public comment until September 12th, the guideline is intended to establish best practices for diagnosis and treatment.
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August 11, 2025

Minnesota Releases PTSD Report

At over 200 pages, this comprehensive report includes a review of PTSD claims in the workers’ comp system.
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August 11, 2025

Pennsylvania Proposes Cannabis Reimbursement Bill

If enacted, insurers would be required to reimburse up to $250 per month for qualified medical use.
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August 11, 2025

Senate Introduces Federal Heat Standard Bill

If enacted, OSHA would be required to adopt a federal standard for enforceable protections.
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August 11, 2025

South Dakota Approves Rulemaking for Physician Fee Schedule

The 2025 Optum RVPs for medical services and treatments will be adopted, but with current conversion factors.
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August 11, 2025

NCCI Reports on Medical Inflation Highlights

While overall medical inflation remains low, certain tariffs are still pending, which could impact long-term costs.
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August 4, 2025

California Publishes 2025 State of the System Report

Medical costs went up 8% in 2024, driven by increased utilization, fee schedule inflation, and growth in medical-legal services.
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August 4, 2025

California Sees Delay to Utilization Review Regulations

The Office of Administrative Law informed the DWC that seven areas of the proposed update required additional clarification or public notice.
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August 4, 2025
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 Further resources you may be interested in

Additional articles and updates from Healthesystems related to policy shaping workers’ comp.

Visit Healthesystems at RISKWORLD 2024

Pick up a copy of the new Summer 2024 edition of RxInformer magazine, and learn how Healthe is transforming healthcare.
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AI Utilization Review Bills Appear Across the Country

California, Georgia, New York, Oklahoma, and Pennsylvania could start a national trend.
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Three More States Introduce Psychedelics Bills, While FDA Sets MDMA Decision Date

Connecticut, Missouri, and New Hampshire join 10 other states considering psychedelics bills.
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2024 Workers’ Comp Industry Insights Survey Report

This sixth annual survey report highlights the top challenges and priorities of 500 industry professionals.
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U.S. Department of Labor Issues Final Rule on Worker Classification

The rule clarifies differences between employees and contractors, establishing who is entitled to benefits – including workers’ comp.
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Ten Psychedelic Bills Introduced Across State Legislatures

States so far include Alaska, Arizona, California, Hawaii, Indiana, Illinois, Massachusetts, Maryland, New Jersey, and Wisconsin.
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